Rules of Engagement

Our ability to come together to express a diversity of opinions is vital to improving the care we give our patients.

As ACR members, we work across the country and in a wide variety of practice situations and areas of focus. We span generations, and our ethnic and cultural backgrounds vary widely, not to mention our political affiliations. Can we really think of ourselves as a team? I’d argue that we must if we are to achieve our organization’s goal: that ACR members are universally acknowledged as leaders in the delivery and advancement of quality healthcare.

The evidence that successful teams are more diverse is overwhelming, and we’re working hard to ensure that our profession reflects the patients we serve. But equally important is that we are able to express a diversity of opinions as we consider how to improve the care we give our patients.

We’re fortunate to meet face-to-face once a year at our annual meeting in Washington, D.C. Our speaker and vice speaker work with the CSC to ensure that the Council meeting and open-mic sessions allow for a variety of opinions to be expressed (see page 15). But in our rapid-paced world, we need to be able to engage in an ongoing conversation between annual meetings to ensure that we are innovating and responding appropriately to changes in our practice environment. Engage, ACR’s member-only discussion forum, which launched in 2016, was designed to do just that. With communities that include subspecialty commissions, state chapters, interest groups such as the RFS, and a variety of ACR committees, there should be a place for every member to have their voice heard. I use the Engage daily digests as a substitute for the face-to-face conversations that I wish I could have with you all. The threads have been almost unanimously collegial and productive. At a time when there is an unfortunate amount of rancor in our political discourse, our community has shown itself to be thoughtful and tolerant of divergent opinions.

But I’ve heard that some members, especially younger colleagues, feel as if they cannot express themselves openly for fear that their opinions might cause them to be viewed negatively. While other platforms allow for anonymous postings, we’ve considered and, so far, rejected that option given the less collegial tone it can promote.

The question of how we enable our ACR team to perform optimally may hinge on our finding a solution to this issue. Research at Google showed that psychological safety (a sense of confidence that the team will not embarrass, reject, or punish someone for speaking up) was critical to a team’s success. Every business school student learns the tragic story of the group think that caused the Challenger disaster. We are familiar with President Abraham Lincoln’s team of rivals — a cabinet containing men who had run against him, were unafraid to take issue with him, and were confident in their own leadership abilities.

The Engage Steering Committee has been ably led by former ACR Vice President Lawrence A. Liebscher, MD, FACR, and his team (see full committee roster at acr.org/ESC), and the expert staff support of Bill Shields, JD, LLM, CAE, Brad Short, MLA, CAE, Trina M. Behbahani, CAE, Katie Kuhn, and Kristin Barnard.

I am committed to hearing what our members have to say even if I don’t agree with it. I will feel as if I have failed as a leader if I do not enable discussions on important topics that are diverse and not always comfortable. I’m approaching this, as is the Engage Steering Committee, with humility. Your ideas on how we can do this better are welcomed, ideally on Engage. But we cannot allow ourselves to be lazy. True innovation requires us to think not just outside the box but outside the room; if we don’t open the door and welcome in those who don’t agree with us, we risk being boxed in to a narrow definition of success. As Marie Curie, a twice-decorated Nobel Laureate and ACR Gold Medal recipient, so wisely said, “Be less curious about people and more curious about ideas.”

By Geraldine B. McGinty, MD, MBA, FACR, Chair

ENDNOTES1. Duhigg C. What Google learned from its quest to build the perfect team. The New York Times. February 25, 2016. Available at bit.ly/PerfectTeam_NYT. Accessed Nov. 5, 2018.2. Gaskings JY. A case study of small group decision-making as influenced by the Abilene Paradox: The Challenger Mishap. Air War College. May 1998. Available at bit.ly/Challenger_Report. Accessed Nov. 5, 2018.3. Coutu D. Leadership lessons from Abraham Lincoln. Harvard Business Review. April 2009. Available at bit.ly/Lincoln_lessons. Accessed Nov. 5, 2018.